Integrated analysis of online signals and insight generation about digital conversations on COVID-19 vaccines in Eastern and Southern Africa: a longitudinal analysis of social listening data.

BACKGROUND: During the COVID-19 pandemic, social listening programs across digital channels have become an integral part of health preparedness and response planning, allowing to capture and address questions, information needs, and misinformation shared by users. This study identifies key social listening trends around COVID-19 vaccines in Eastern and Southern Africa and analyses how online conversations about this issue evolved over time. METHODS: A taxonomy developed and refined in collaboration with social and behaviour change teams was used to filter online conversations into nine subtopic categories. The taxonomy was applied to online content tracked in 21 countries in Eastern and Southern Africa over the period December 1, 2020-December 31, 2021. Metrics captured included volume of posts or articles and related user engagement. Qualitative analysis of content was conducted to identify key concerns, information voids and misinformation. RESULTS: Over 300,000 articles and posts about COVID-19 vaccines shared by users or outlets geolocated in the region were analysed. These results generated over 14 million engagements on social media and digital platforms. The analysis shows how conversations about access and availability of vaccines represented the largest share of engagement over the course of the period. Conversations about vaccine effectiveness and safety represented the second and third largest share of engagement, with peaks observed in August and November 2021. Online interest in childhood vaccination increased over time as vaccine eligibility criteria expanded in some countries in the region. Conversations mentioning mandates and certificates peaked in the last quarter of 2021, as governments as private sector entities expanded vaccine requirements. CONCLUSIONS: Findings from this study show the importance of monitoring conversation trends over time and adjust social listening data collection systems to include emerging topics. The study also points to the need to consider concerns, information voids and misinformation around effectiveness and safety of vaccines in the context of overall concern for vaccine availability and access in Eastern and Southern Africa. This is fundamental to inform social and behaviour change strategies that promote vaccine demand effectively, without increasing public frustration over vaccine availability challenges and downplaying concerns around vaccine equity.

Community-Based Approaches to Increase COVID-19 Vaccine Uptake and Demand: Lessons Learned from Four UNICEF-Supported Interventions.

Vaccination is critical to minimize serious illness and death from COVID-19. Yet uptake of COVID-19 vaccines remains highly variable, particularly among marginalized communities. This article shares lessons learned from four UNICEF interventions that supported Governments to generate acceptance and demand for COVID-19 vaccines in Zambia, Iraq, Ghana, and India. In Zambia, community rapid assessment provided invaluable real-time insights around COVID-19 vaccination and allowed the identification of population segments that share beliefs and motivations regarding COVID-19 vaccination. Findings were subsequently used to develop recommendations tailored to the different personas. In Iraq, a new outreach approach (3iS: Intensification of Integrated Immunization) utilized direct community engagement to deliver health messages and encourage service uptake, resulting in over 4.4 million doses of COVID-19 and routine immunization vaccines delivered in just 8 months. In Ghana, a human-centered design initiative was applied to co-develop community-informed strategies to improve COVID-19 vaccination rates. In India, a risk communication and community engagement initiative reached half a million people over six months, translating into a 25% increase in vaccination rates. These shared approaches can be leveraged to improve COVID-19 vaccination coverage and close gaps in routine immunization across diverse and marginalized communities.

Measuring behavioral and social drivers of COVID-19 vaccination in health workers in Eastern and Southern Africa.

BACKGROUND: In 2021, twenty out of twenty-one countries in the Eastern and Southern Africa (ESA) region introduced COVID-19 vaccines. With variable willingness to uptake vaccines across countries, the aim of the present study was to better understand factors that impact behavioral and social drivers of vaccination (BeSD). Using the theory-based "increasing vaccination model", the drivers Thinking & Feeling, Social Processes, Motivation, and Practical Issues were adapted to the COVID-19 context and utilized in a cross-country assessment. METHODS: Data was collected on 27.240 health workers in Kenya, Malawi, Mozambique, South Africa and South Sudan. This was done by administering a survey of seven target questions via the UNICEF Internet of Good Things (IoGT) online platform between February and August 2021. RESULTS: Findings showed a gap between perceived importance and trust in vaccines: Most health workers thought Covid-19 vaccination was very important for their health, while less than 30% trusted it very much. The pro-vaccination social and work norm was not well established since almost 66% of all respondents would take the vaccine if recommended to them, but only 49% thought most adults would, and only 48% thought their co-workers would. Access was highlighted as a crucial barrier, with less than a quarter reporting that accessing vaccination services for themselves would be very easy. Women exhibited slightly lower scores than men across the board. When testing the associations between drivers in Kenya and South Africa, it appears that when target interventions are developed for specific age groups, social norms become the main drivers of intention to get vaccinated. CONCLUSIONS: The present study revealed various key relations with demographic variables that would help immunization programmes and implementing partners to develop targeted interventions. First, there is a serious gap between perceived importance of COVID-19 vaccines and how much trust people in them. Second, problems with access are still rather serious and solving this would strongly benefit those who demand a vaccine, Third, the role of social norms is the most important predictor of willingness when considering age differences.

[Brain food reward alterations in obesity]. / Bases cérébrales de la récompense alimentaire : en quoi sont-elles affectées dans l'obésité ?

Obesity, defined by body fat excess, results from a food intake which exceeds energy needs. The control of this intake is compromised in people suffering from obesity. There is a disturbance of the food reward brain network, in the form of an abnormal reactivity to visual and gustatory food signals and a disrupted influence of the state of hunger on its activity as well as an alteration in the dopaminergic neurotransmission. Eating would thus be leaded more by its hedonic supply rather than physiological needs and this imbalance would appear among the mechanisms underlying overeating behavior. A better understanding of obesity neurobiology would ultimately contribute to the improvement of therapies and preventive measures.

L'obésité, se définissant par un excès de graisse corporelle, résulte d'un apport alimentaire outrepassant les besoins énergétiques. Le contrôle de cet apport est compromis chez des personnes en situation d'obésité. Il existe une perturbation du réseau neuronal de la récompense alimentaire, sous forme d'une réactivité anormale aux signaux alimentaires visuels et gustatifs, d'une influence dénaturée de l'état de faim sur son activité et d'une altération de la neurotransmission dopaminergique. L'alimentation serait ainsi davantage guidée par son apport hédonique plutôt que par les besoins physiologiques et ce déséquilibre figurerait parmi les mécanismes sous-jacents au comportement de surconsommation alimentaire. Une meilleure compréhension de la neurobiologie de l'obésité contribuerait aux progrès thérapeutiques et mesures préventives.

Validation and Psychometric Assessment of the Practice Environment Scale of the Nursing Work Index in the Portuguese Hospital Context.

BACKGROUND: The nursing work environment has an impact on patient safety outcomes and its measurement should be a regular practice. PURPOSE: To assess the reliability and construct validity of the Practice Environment Scale of the Nursing Work Index in the Portuguese context. METHODS: An exploratory factor analysis followed by a confirmatory factor analysis to assess model adjustment quality was performed with a sample of 3,686 nurses. RESULTS: The final solution for the exploratory factor analysis comprised 26 items and five factors (56.6% of the total variance). The confirmatory factor analysis, after refinement, showed a stable factor structure. CONCLUSIONS: The final model showed good construct validity and high reliability, which supports the decision to exclude the items that are not essential to the construct being measured.

Short-term association between exposure to ozone and mortality in Oporto, Portugal.

Exposures to air pollution in developed countries have generally decreased over the last two decades. However, many recent epidemiological studies have consistently shown positive associations between low-level exposure to air pollutants and health outcomes. In Portugal, very few studies have analysed the acute effect of air pollutants on health. The present study evaluates the association between exposure to air pollution and daily mortality in the Oporto Metropolitan Area, Portugal. Generalised additive models were used for this analysis. Pollutants assessed were ozone, nitrogen dioxide, and particulate matter (PM(10)). Models were adjusted for time trend, seasonality, and weather. We report that an increase of 10 µg/m(3) in the daily ozone 8-h maximum moving-average corresponds to an increase of 0.95% (95%CI: 0.30, 1.60) and 1.58% (95%CI: 0.45, 2.73) in non-accidental mortality and cardiovascular mortality, respectively, in the summer season. A significant effect of 0.67% (95% CI: 0.03:1.32) was also found for the association between PM(10) and non-accidental mortality in the summer season. Associations with ozone and PM(10) exposures were higher in the elderly people. No significant effects on mortality were observed during the summer season with nitrogen dioxide exposures. Our analyses provide the first significant evidence in Oporto that exposures to O(3) and PM(10) have adverse effects on the health of the general population in the summer months.

[Self-reported hearing-loss in the Portuguese population: evidence from the 4th National Health Survey]. / Incapacidade auditiva autodeclarada na população Portuguesa: uma análise aos dados do quarto Inquérito Nacional de Saúde.

UNLABELLED: Hearing loss is associated with a negative social impact, which implies a lower quality of life. Despite its negative consequences the prevalence of hearing loss in the Portuguese population is not well known. OBJECTIVE: The aim of this study was to assess the prevalence of self-reported hearing loss, in a representative sample of the Portuguese population. METHODS: We analysed data from the 4th Portuguese National Health Survey (2005-2006), conducted by the National Institute of Health, Dr. Ricardo Jorge and the National Institute of Statistics. Participants were selected from households in the seven regions of Portugal (NUTS II classification), using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, and hearing loss situation. The prevalence of self-reported hearing loss was estimated by sex, age group, región and level of education. RESULTS: The prevalence of self-reported hearing loss was higher in men, and increased with age, in both sexes. The crude prevalence of hearing loss was higher in Alentejo region (11,0% in men and 9,5% in women) than in any other Region. After age-adjustment, the Northern región had the highest percentage (11,6%), and the Alentejo region the second value (9,7%). The Madeira Region had the lowest age-adjusted prevalence (5,0%). The percentage of hearing loss decreased with higher education, for most age groups both in men and women. CONCLUSIONS: This study showed that hearing loss was associated with high age groups, male gender and lower level of education. Facing this situation, it is important to promote epidemiological and clinical investigation about hearing loss, including associated exposures and their distribution in Portuguese populations.